psychopathology Flashcards
definitions of abnormality - statistical infrequency
. when individual has less common characteristics, ex. being more depressed/less intelligent than most people
. ex. IQ/intellectual disability disorder
. average IQ is 100 in normal distribution, most people score range of 85-115 (68%), only 2% people score below 70
. people below 70 are seen as abnormal
definitions of abnormality - deviation from social norms
. beh. that’s diff. from accepted standards of beh. in community/society
. group of people choose to define beh. as abnormal on basis that it offends their sense of what the norm is
. norms r specific to culture we live in
. however social norms may be diff. for each generation/culture
. few beh. considered universally abnormal
evaluation - real world application for statistical infrequency
. strength
. usefulness in clinical practice for formal diagnosis and assess severity
. ex. becks depression inventory
. therefore shows value of statistical infrequency criterion, useful in diagnostic/assessment procedures
evaluation - unusual characteristics can be +ve. ; statistical infrequency
. limitation
. infrequent charac. can be +ve as well as -ve
. people don’t think someone is abnormal for having a high IQ or low depression score
. therefore SI can form part of the assessment/diagnostic procedures but never sufficient as sole basis of defining abnormality
evaluation - real world application for deviation from social norms
. strength
. deviation used in clinical practice
. ex charac. of antisocial personality disorder are aggression
. these signs r deviations from social norms
. therefore shows deviation from social norms criterion has value in psychiatry
evaluation - cultural and situation relativism ; deviation from social norms
. limitation
. variation b/w social norms is diff b/w cultures/situs
. pers. fr. one cultural group may label someone from another group as abnormal using their standards than the persons
. even w/n one cultural context social norms differ
. ex. aggression/deceit in family is unacceptable but ok in business
. therefore shows difficult to judge deviation from social norms across diff. situs. and cultures
deviations from abnormality - failure to function adequately
. no longer cope with demands of everyday life
. rosenhan/seligman; proposed additional signs :
. when person no longer conforms to standard interpersonal rules
. when person experiences severe distress
. when persons beh. becomes irrational/danger to themselves/others
definitions of abnormality - deviation from ideal mental health
. jahoda ; suggested we r in good mental health if we fit the criteria :
. no symptoms/distress
. rational/perceive ourselves accurately
. self actualise
. can cope w. stress
. have realistic view of the world
. have good self esteem
. independent of others
. can successfully work, love, enjoy leisure
. inevitably there is an overlap between ideal mental health and failure to function
evaluation - real world application for failure to function
. strength
. represents threshold for when people need professional help
. tends to be at point we cease to function adequately that people seek professional help/referred to by others
. this criterion means treatment/services can be targeted to those who need them most
evaluation - discrimination/social control ; failure to function
limitation
. easy to label non-standard lifestyle choices abnormal
. hard to say if someone failing to function or deviating from social norms
. those who favour high risk leisure may seen as abnormal
. therefore shows people who make unusual choices at risk of being labelled abnormal/freedom of choice limited
evaluation - comprehensive definition; deviating ideal m health
strength
. highly comprehensive
. includes range of criteria distinguishing m. health fr. m. disorder
. individuals health discussed meaningfully w. range of prof.
. shows ideal m. health provides checklist against which we can use ourselves/ discuss psychological issues w. range of professionals
evaluation - culture bound ; deviation from ideal m health
limitation
. diff elements not equally applicable across range of cultures
. some jahodas criteria firmly located in US/europe context
. therefore difficult to apply concept of ideal m health from 1 culture to another
DSM-5 categories of phobia
. characterised by fear/anxiety triggered by object/situ
. fear is out of proportion
. specific phobia ; phobia of object/situ
. social anxiety ; phobia of social situ
. agoraphobia; phobia of being outside/public
behavioural characteristics of phobias
. panic ; may involve lying, screaming, running away
. avoidance ; a lot of effort to prevent coming into contact with phobia, can be hard to go about daily life ie. school/work
. endurance ; person chooses to remain in presence of phobia
emotional characteristics of phobias
. anxiety ; unpleasant state of arousal, prevents relaxing
. fear ; immediate/extremely unpleasant response, shorter than anxiety
. unreasonable ; anxiety/fear greater than ‘normal’, disproportionate
cognitive characteristics of phobias
. selective attention to phobic stimulus ; keep attention on phobia
. irrational beliefs ; person may hold unfounded thoughts in relation to phobic stimuli
. cognitive distortions ; perceptions may be inaccurate/unrealistic
DSM-5 categories of depression
. major depressive disorder ; severe but short term
. persistent depressive disorder ; long term/recurring, including maj. dep.
. disruptive mood dysregulation disorder ; childhood temper tantrums
. premenstrual dysphoric disorder ; disruption to mood with menstrual cycle
behavioural characteristics of depression
. activity levels ; reduced, lethargic/withdraw from school/work, psychomotor agitation : individual struggle to relax
. disruption to eating/sleeping ; insomnia/hypersomnia, appetite increases/decreases wh. may lead to weight gain/weight loss
. aggression/self harm ; verbally/physically aggressive, self harm
emotional characteristics of depression
. lowered mood; daily lethargic/sad, sees themselves as ‘worthless’
. anger ; directed at self/others, can be extreme
. lowered self esteem; self loathe
cognitive characteristics of depression
. poor conc. ; unable to stick to task, interferes w. work
. dwelling on -ve. ; pay attention to -ve events, bias towards unhappy events
. absolutist thinking ; ‘black and white thinking’
behavioural characteristics of ocd
. compulsions are repetitive
. compulsion reduce anxiety
. avoidance ; avoid situs that triggers anxiety/interferes with regular life
emotional characteristics of ocd
. anxiety/distress; unpleasant/overwhelming
. accompanying depression; low mood, lack of enjoyment
. guilt/disgust ; -ve emotions about self/situ
cognitive characteristics of ocd
. obsessive thoughts ; vary from person to person, unpleasant
. cognitive coping strategies; may manage anxiety but distracting
. insight into excessive anxiety ; r aware they r not rational but experience catastrophic thoughts
behavioural approach to explaining phobias - two process model
. mowrer; proposed model based on behavioural approach to phobias
behavioural approach to explaining phobias - acquisition by classical conditioning
. learning to associate something of no fear (NS) with something that triggers fear response
. watson/rayner; ‘little albert’, created phobia in 9 month baby
. had no fear to rat but when experimenters gave albert the rat they made loud noise
. noise = UCS wh. created UCR of fear, when rat and noise set close together NS stimulus became associated with UCS and both produce fear response now
. rat now CS that produces CR
. conditioning generalised to similar objects ie. non-white rabbit
behavioural approach to explaining phobias - maintenance by operant conditioning
. phobias long lasting due to OC
. OC happens when beh. rewarded/punished
. reinforcement increases freq. of beh.
. mowrer; when we avoid phobic stimulus we successfully escape fear/anxiety that we would have experienced if remained
. reduction in fear reinforces avoidance beh. so phobia maintained
evaluation - real world application of beh. appr. explaining phobias
. strength
. in exposure therapies
. phobias maintained by avoidance so exposure is good
. once avoidance beh. prevented it ceases to be reinforced by experience of anxiety reduction so avoidance declines
. therefore shows value of two process model bec. it defines a means of treating phobias
evaluation - cognitive aspect of phobias ; beh. appr. explaining phobias
limitation
. does not account for cognitive aspects
. geared towards explaining beh.
. there is significant cog. component ex. irrational beliefs
. therefore shows 2 process model does not completely explain symptoms of phobias
evaluation - phobias/traumatic experiences ; beh. appr. explaining phobias
strength
. link b/w bad experiences and phobias
. ex. little albert study
. jongh et al; found 73% people w. dentist fear experienced traumatic experience
. this confirms associated b/w stimulus and UR does lead to development of phobia
evaluation - phobias/traumatic experiences 2 ; beh. appr. explaining phobias
limitation
. not all phobias fr. bad experiences
. not all bad experiences lead to phobias
. therefore shows association b/w phobia/experience not as strong as expected
behavioural approach to treating phobias - systematic desensitisation
. behavioural therapy to reduce phobic anxiety thru classical conditioning
. counter conditioning involves ;
. anxiety hierarchy ; lost of situs, low levels to high
. therapist teaches pers. how to relax deeply
. reciprocal inhibition
. exposure to phobia in relaxed state, start at bottom of hierarchy and across sev. sessions
. successful when client stays relaxed
behavioural approach to treating phobias - flooding
. immediate exposure to v. frightening situ.
. longer than SD
. stops responses quickly
. extinct CC
. learned response extinguished when CS encountered w/o US
. CS does not produce CR
. clients must give informed consent
evaluation - evidence of effectiveness ; beh. treat. of phobia
. gilroy et al ; followed 42 people who had SD 4 spider phobia
. at both 3/33 months, SD g. less fearful than a control
. SD effective for specific p. social p. and agoraphobia
. therefore shows SD likely to help people with phobias
evaluation - learning disabilities; beh. treat. of phobias
strength
. can help people with learning disabilities
. main SD alternat. not suitable for LDs
. LD people may feel confused/distressed by ex. flooding
. therefore shows SD often most appropriate treat. for LD people with phobias
evaluation - cost effective ; beh. treat. of phobias
strength
. highly cost effective
. flooding can work in one session compared to 10 sessions of SD
. clinically effective / not expensive
. therefore shows more people can be treated at same cost w. flooding than w. SD or others
evaluation - traumatic ; beh. treat. of phobias
limitation
. highly unpleasant experience
. surah et al ; fou, ppts/ therapist rate flooding +re stressful than SD
. dropout rates (attrition) 4 flooding higher than SD
. therefore suggests overall therapists may avoid this treatment
cognitive approach to explaining depression - becks -ve triad
. cognitive vulnerability
. faulty info processing ; depressed people attend to -ve aspects of situ/ign. +ves, ‘black and white thinking’
. negative self schema ; self schema, package of info about yourself, pers. w. -ve self schema interpret info about themselves in -ve way
. negative triad ; person develops dysfunctional view of themselves bec. 3 types of -ve thinking:
. -ve view of world, future, self
cog. approach to explaining depression - Ellis’s ABC model
. poor mental health res. fr. irrational thoughts
. irrational thought is any thought that interferes w. us being happy
. ABC model ;
. 1 . activating event A ; get depressed when experience -ve events, these trigger irrational beliefs
. 2 . beliefs B ; ‘musturbation’ , must always succeed/maj disaster when something doesn’t go smoothly have a ‘utopianism’ view of life and think everything must be fair
. 3 . consequences C ; active. event trigg. irrational beliefs, there r emotional/behavioural consequences
evaluation - research support for becks -ve triad
. clark/beck; fou. cog. vul. +re common in depressed people b. also preceded the depression
. cohen et al; tracked 473 adolescents develop. and found those showing cog. vul. predicted later depression
. therefore shows association b/w cog. vul./depression
evaluation - real world application for becks -ve triad
strength
. appli. in screening/treatment 4 depression
. cohen et al; concl. assessing cog. vul. allows psychiatrists to screen young people and identifies those at risk
. therapies can alter cognitions that make people vul. 2 dep.
. therefore means understanding cog. vul. useful in +re than 1 clinical setting
evaluation - real world application of ABC model
strength
. psychological treatment of dep.
. rational emotive behavioural therapy REBT
. vigorously arguing with depressed person can alter irrational beliefs
. REBT can change -ve beliefs / relieve symp. of dep.
. REBT has real world value
evaluation - reactive/endogenous depression
limitation
. ABC model on,y explains reactive depression not endogenous
. many cases of depression not trace to life events
. Ellis’s model can only explain some cases of depression
. therefore ABC model only partial explanation
cog. appr. to treating depression - beck’s cog. therapy
. applic. of becks cog theory of dep.
. indentify -ve triad, thoughts must be challenged
. central component of therapy
. cog. therapy help clients test reality of their -ve beliefs
. ‘clients as scientist’ giving them h/w to record +ve things
cog. appr. to treating depression - Ellis’s REBT
. REBT extends ABC model
. ABCDE model; D = dispute and E = effect
. empirical argument; disputing whether there’s actual evidence
. logical arguments ; vigorous argument
cog. appr. to treating depression - behavioural activation
. depressed individual tend to avoid difficult situs and become isolated which maintains/worsens symptoms
. goal of BA to work w. depressed individual 2 gradually decrease avoidance/isolation so increases engagement in activities that have been shown 2 improve mood
evidence 4 effectiveness of cog. therapy
strength
. supports effectiveness 4 treatment of dep.
. march et al; compared CBT 2 antidepressants
. 327 dep. adolescents; after 36 weeks 81% of CBT + 81% of drugs grp improved, combo grp. improved 86%
. CBT just as effective as drugs/cost effective
. therefore means CBT seen as 1st choice of treatment in public health
cog. therapy suitability for diverse clients
. limitation
. lack of effectiveness for severe cases/LD people
. some people cannot engage bec. they’re so depressed
. sturmey; suggests psychotherapy not suitable 4 people w. LD
. therefore suggests CBT only appropriate for specific range of dep. people
cog. therapy suitability for diverse clients counterpoint
strength
. CBT as effective as drug
. taylor et al; when CBT used appropriately it can be good for LD people
. CBT may be suitable for wider ranger of people than once thought
evaluation - relapse rate; cog. appr. to treating depression
limitation
. CBT treatment of depression is high relapse rates
. CBT for dep. not long term
. Ali; 439 clients every month for 12 months found 42% relapsed w/n 6 months and 53% w/n a yr
. CBT may need to be repeated
biological appr. to explaining OCD - genetic explanations
. genes involved in individual vulnerable to ocd
. lewis; 37% had parents w. ocd, 21% siblings w. ocd
. suggests ocd runs in families, gen. 2 gen.
. diathesis stress model; certain genes leaves some people +re likely 2 get mental disorder
. some environmental stress
biological appr. to treating OCD - candidate genes
. genes that create vulnerability
. some are involved in regulating development of serotonin system
biol. appr. to explaining OCD - ocd polygenic
. caused by combo of genetic variations together increasing vulnerability
. taylor; found up to 230 diff. genes may be involved
ex. genes for dopamine and serotonin production
biological appr. to explaining ocd - diff. types of ocd
. 1 gene may cause ocd in person but diff. gene cause diff. ocd in another
. evidence suggests that diff. types of ocd may be result of particular genetic variations (aetiologically heterogenous)
biological appr. to explaining ocd - neural explanation
. serotonin; low lev. causes low moods
. associated w. ocd
evaluation - research support for genetic explanations; biological explan. for ocd
strength
. genetic explanations strong evidence base
. twin studies
. 68% identical shared ocd opposed to 31% non identical
. pers. w. family memb. w. ocd 4x +re likely 2 get ocd
. therefore suggests must be some genetic influence on ocd
evaluation - environmental risk factors of biological expl. of ocd
limitation
. ocd not entirely genetic
. ex. cromer; half ocd clients experienced trauma
. therefore shows genetic vulnerability provides partial explanation
evaluation - research support for biological expl. of ocd
strength
. antidepressants works only on serotonin, reduces ocd
. suggests serotonin may be involved in ocd
. sugg. bio. factors may also be responsible 4 ocd
evaluation - research support for biological explanations of ocd
limitation
. co-morbidity
. depression probably involves disruption 2 action of serotonin
. therefore means serotonin not relevant 2 ocd
biological approach to treating ocd - SSRIs
. particular type of antidepressant drug
. works on serotonin system in the brain
. SSRIs effectively increase levels of serotonin in the synapse and continue to stimulate the postsynaptic neurone
. for 3-4 months daily use 4 SSRIs 2 have impact on symptoms
biological approach to treating ocd - combining SSRIs w. other treatment
. drugs used alongside cog. beh. therapy
. drugs reduce persons emotional symptoms
. so can respond to CBT +re effectively
biological approach to treating ocd - alternative to SSRIs
. after 3-4 months w. no effect dose can increase
. can combine w. other drugs
. alternatives may work :
. tricyclics ; +re severe side effects, reserve 4 SSRIs
. SNRIs ; second line of defence
evaluation - evidence of effectiveness; biological treatment of ocd
strength
. clear evidence shows SSRIs reduce symptoms severity/ improve quality of life
. 17 studies; compared SSRIs w. placebos
. all 17 showed improvement w. SSRIs
. drugs appear to be helpful 4 most w. ocd
evaluation - evidence of effectiveness counterpoint ; biological treatment of ocd
limitation
. drugs may not be most effective
. shapinahis et al; concluded both cog./behavioural therapies were +re effective than SSRIs in treatment
. therefore means drugs may not be best treatment
evaluation - cost effective/non disruptive ; biological treatment of ocd
. drug treatments r cheap, 1000s of tablets can be manufactured in the time of 1 session
. drugs good value 4 public health
. SSRIs non disruptive
. drugs popular w. people and doctors
evaluation - serious side effects ; biological treatments of ocd
limitation
. small minority have no benefit
. SEs usually temporary but can be distressing
. therefore means some people have reduced quality of life as result of taking drugs/may stop taking them
